Capernaum Autism Center LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

CAPERNAUM AUTISM CENTER LLC

Practice address

2024 Edgewood Dr S
Lakeland, FL 33803-3637

Phone

(813) 553-8253

NPI assigned

Dec 2, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vijay Dasika

Title

Administrator

Phone

(813) 553-8253

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1215899711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 EDGEWOOD DR S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 EDGEWOOD DR S",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033637",
            "telephone_number": "813-553-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPERNAUM AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-02",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "DASIKA",
        "authorized_official_first_name": "VIJAY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-553-8253"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cara Marjorie Anne Cannon
• Jeremy Jon Cannon
• Hilda Valbrun Canon, APRN
• John Gerald Galvez Canto, MD
• Theresa Cao, D.O.
• Capernaum Medical Center
• Capernaum Medical Center for Kids PLLC
• Capernaum Medical Center for Kids PLLC
• Capernaum Medical Center for Kids PLLC
• Alison Caracciola, BCBA

• Behavior Analyst in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.